Test 4/Week 9: GU

Question 1

UA Findings

Answer 1

Clear/cloudy, <3 RBCs, <150 protein, <2-5 WBCs, negative for: nitrites, leukocyte esterase, crystals, bacteria, yeast

Question 2

BUN/Cr Ratio

Answer 2

Normal: 10-20 (BUN / Cr)
Increased: fluid deficit
Decreased: fluid overload
Indicator of GFR

Question 3

Creatinine Clearance

Answer 3

(Urine Cr / Serum Cr) x (urine volume mL / time in hrs x 60)

24hr urine collection

Question 4

Radiographic Renal Angiogram

Answer 4

Visualizes renal blood flow, needs IV access, enema prior depending on policy

Question 5

Renal Biopsy

Answer 5

Coag studies first

Post: BP q15min, compare UO to pre, severe pain indicates hematoma (call MD)

Question 6

Acute Pyelonephritis

Answer 6

Assess for UTI

Question 7

Complicated UTI Assessment

Answer 7

No costavertebral tenderness, no palpable organs/masses, IVF, ABx, analgesics, no catheters

Question 8

Immune Disease Risk Factors for Glomerulonephritis

Answer 8

Lupus

Question 9

Acute kidney/glomerular disease

Answer 9

inflammation of glomeruli: Hematuria (rust color), proteinuria

Question 10

Chronic kidney/glomerular disease

Answer 10

Scarring of glomeruli/tubules: proteinuria, bubbly/foamy urine, frequent nocturia (3-6/night), increased BUN/Cr, decreased GFR

Question 11

Nephrotic Syndrome

Answer 11

Increased glomerular membrane permeability, massive protein loss leads to low plasma albumin

Question 12

Nephrotic Syndrome Assessment

Answer 12

Hypoalbuminemia, hypercoagulability, thromboembolism

Question 13

Nephrotic Syndrome Teaching

Answer 13

Low sodium 2-3g/day, moderate protein 1-2g/kg/day

Daily weight (shouldn’t gain more than 2 lbs in a day)

Avoid exposure to infected people (lowered immune system from steroid therapy or autoimmune disorders)

Question 14

Polycystic Kidney Disease Assessments

Answer 14

HTN first sign, severe flank pain, hematuria